Non-allergic rhinitis is a distinct disease classification, separate from allergic rhinitis, which is characterized by an IgE-mediated response. The diagnosis of non-allergic rhinitis encompasses several individual classifications, including NARES, as well as vasomotor, occupational, hormonal, infectious, drug-induced, and gustatory conditions. A wide variety of medications are available for the treatment of associated symptoms. However, no individual class of medications or single medication is ideal for managing the entire spectrum of symptoms. Surgical therapy may be warranted in particular patients with non-allergic rhinitis refractory to proper medical management. Patients are best treated to manage their unique symptoms and to correct the causes. Nasal mucosa has rich blood supply and has venous sinusoids which are surrounded by smooth muscle fibers. These smooth muscle fibers act as sphincters and control the filling and emptying of sinusoids. Sympathetic stimulation causes construction of blood vessels and shrinkage of mucosa leading to decongestion of nose. Parasympathetic stimulation causes not only excessive secretion from the nasal gland but also vasodilatation and engorgement, which lead to rhinorrhoea and congestion of nose. The autonomic nervous system, which supplies the nasal mucosa, is under the control of hypothalamus. Therefore, emotions play significant role in non-allergic rhinitis.
The present study aimed to assess time trends in the prevalence of current asthma, asthma-like symptoms and allergic rhinitis in Italian adults from 1990 to 2010. The same screening questionnaire was administered by mail or phone to random samples of the general population (age 20-44 yrs) in Italy, in the frame of three multicentre studies: the European Community Respiratory Health Survey (ECRHS) (1991-1993; n = 6,031); the Italian Study on Asthma in Young Adults (ISAYA) (1998-2000; n = 18,873); and the Gene Environment Interactions in Respiratory Diseases (GEIRD) study (2007-2010; n = 10,494). The majority of studies show a clear benefit on the use of intranasal corticosteroids over either sedating or nonsedating antihistamines for relief of symptoms of nasal allergy. With respect to symptom alleviation in seasonal and perennial allergic rhinitis, study results indicate no consistent differences between sedating and nonsedating antihistamines, though the side-effect profile favors nonsedating antihistamines. No randomized controlled trials were identified that compared immunotherapy with antihistamines or with nasal corticosteroids in the treatment of seasonal and/or perennial allergic rhinitis.